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�,, Marion County Public Works <br /> .Ill '''�llu,,l� Building Inspection Division <br /> 5155 Silverton Rd NE <br /> Salem OR 97305 <br /> (503) 588-5147 Fax(503) 588-7948 <br /> http://wwvv/co.marion.orus <br /> ON-SITE SYSTEM MATERIAL LIST <br /> (DIRECTIONS&DEFINITIONS ON BACK) <br /> CK) <br /> ADDRESS / air ,- F —QC7zi (1 57,042 X LOT# / ® 0-1-C'. 4-C)3c o0 <br /> SECTION TOWNSHIP RANGE LOT <br /> 1. SEPTIC TANKS �-�j I / <br /> SEPTIC TANK: MFG. F 'I1 .. a- v CAPACITY MATERIAL <br /> O DOSING TANK:MFG. CAPACITY MATERIAL <br /> O SEPTIC/DOSING TANK: 0 SINGLE COMPARTMENT 0 TWO COMPARTMENT 0 FLOW-THROUGH <br /> MFG. CAPACITY MATERIAL <br /> MFG.'S SPECS. INCLUDED ❑ <br /> 2. PUMPING ASSEMBLIES <br /> PUMP 1: MFG. MODEL (INCLUDE PERFORMANCE CURVE) 0 <br /> PUMP 2: MFG. MODEL (INCLUDE PERFORMANCE CURVE) 0 <br /> CONTROL PANEL: MFG. MODEL 0 <br /> HYDROSPLITTER: MFG. M•■EL (INCLUDE ORIFICE CALCULATIONS) 0 <br /> , <br /> EFFLUENT FILTER: MFG. - c 0 <br /> DISTRIBUTION VALVE:MFG. MODEL ❑ <br /> 3. EFFLUENT TRANSPORT PIPING <br /> O GRAVITY EFFLUENT SEWER: LENGTH DIAMETER MATERIAL FALL(IN INCHES) <br /> O PRESSURE PIPING: LENGTH DIAMETER MATERIAL PSI <br /> 4. DISPOSAL FIELD(DRAINFIELD) <br /> DISTRIBUTION TECHNIQUE: 0 EQUAL 0 LOOP 0 SERIAL 0 PRESSURIZED <br /> TOTAL LINEAR FOOTAGE: <br /> DRAIN MEDIA: 0 GRAVEL-LESS ABSORPTION METHOD 0 ROCK&PIPE 0 OTHER <br /> TOTAL DEPTH DEPTH BELOW PIPE <br /> TRENCH DEPTH(FROM ORIGINAL GROUND SURFACE): MIN MAX <br /> CAPPING FILL DEPTH(DEPTH OF CAP): <br /> SETBACKS FROM WELLS: SEPTIC TANK SAND FILTER OR ATT UNIT DRAINFIELD <br /> 5. DEWATERING SYSTEMS(IF REQUIRED) <br /> ❑. CURTAIN DRAIN 0 TILE DEWATERING <br /> TRENCH DEPTH: CERTIFIED <br /> • MEDIA: 0 ROCK&PIPE ❑OTHER STATE <br /> Environmental Health Specialist <br /> TOTAL DEPTH DEPTH BELOW PIPE 0 FILTER FAB IC EH: -1 206 40 <br /> PERFORATED PIPING: DIAMETER MATERIAL <br /> 6. ADVANCED TREATMENT UNITS <br /> O SAND FILTER 0 RGF ❑ ATT: TYPE Robert Goodwin <br /> e-` <br /> G:IBUILDING INSPECTIONTORM.SISEPTIC\FORMS\S-60 MATERIALS LIST.DOCX Rev 3/18 <br />